NEW BORN

Nothing can prepare you for the overwhelming mixture of emotions you feel when your baby finally arrives. After all those long months of waiting, you can finally get to see and hold him/her and now parenting becomes very real! Don’t worry if you don’t feel all the emotions you think you should – your hormones will be all over the place and you’re bound to find that some things are not quite as you’d imagined. But hang in there…you are the perfect mom for your child!

Lots of moms are surprised at how their newborn looks, and many feel a little ‘let down’ by their baby’s appearance immediately after birth. If this is the case, don’t worry…all those newborn features will quickly fade. How he was positioned in your uterus and how he was delivered (Caesarean section versus normal vaginal birth, with/without the use of forceps) can both temporarily affect his appearance – but this will soon settle.

An elongated, swollen and/or bruised head

Baby’s skull bones are soft at birth to allow his head to pass through the birth canal. A vaginal birth can mould her head into a slight cone shape but this only lasts a few days. Your baby may also have a soft tissue swelling on her head called a caput, which sometimes results from it pressing against the dilating cervix during contractions – or by the suction of a vacuum delivery. It’s a harmless swelling that should disappear in a matter of days, as should any bruising. As your baby grows, be careful to vary your baby’s sleeping positions so that she is not lying on the same spot on her head every time, as this can cause the skull to become flat in that area.

Fontanelles

Your baby may have a soft, pulsating spot on the top of her head, called the anterior fontanelle. Your baby actually has two fontanelles, which are gaps where the skull bones have not yet fused. They allow her head to grow rapidly in her first year and also act as a cushion to protect her head from injury. Although fontanelles look very vulnerable, they are actually covered by quite tough tissue so you won’t hurt your baby by gently washing and combing the area. Fontanelles usually close by about the age of 2.

A squashed face

Your baby’s nose may look a little flat and even pushed to the side, and her eyes may look bloodshot and her eyelids puffy. All these are normal and should improve quickly over a day or two. Don’t try to force your baby’s eyes open if she is initially reluctant to open them.

Vernix and hair

At birth, most babies are covered with blood and mucous along with a protective layer of vernix – a white, greasy layer that keeps the baby’s skin from becoming waterlogged. Many babies have a layer of fine hair over their skin called lanugo, which falls out during the first few months. Your baby may have lots of hair on her head or almost none. Don’t worry if some of it falls out, especially fine, wispy hair. It will soon grow back, and you may see quite a few other changes in hair colour and texture as your baby grows.

Baby skin

Don’t worry if your baby’s skin breaks out in a variety of rashes and blotches – most of these are hormonal and/or due to your baby’s body adjusting to her new world. These usually disappear within a few days or weeks. Very occasionally a rash can be an early sign of infection that will need treatment, so do always get them checked by your doctor or clinic.

Dry skin

This is common, especially in babies born a bit late because the vernix will have worn off, leaving the skin unprotected. Dry patches should improve within a few weeks and can be helped with a mild, fragrance-free moisturiser. Peeling skin in the groin of newborns is very common and does not require any treatment.

Sweating

It is normal for babies to be sweaty as their bodies tend to overcompensate for their new environment.

Mottled skin and visible veins

Mottled skin is quite normal and is due to immature circulation of the blood. Your baby’s skin is also very thin, making veins very easy to see.

Cradle cap

Cradle cap is the name given to yellowish crusts that develop on the scalp, eyebrows and behind the ears. The underlying cause is unknown so treatment involves softening the crusts as they form so that they can be painlessly removed. To soften and remove the crust from eyebrows and/or behind ears, massage a little sorbolene and glycerine into the affected area at every nappy change, then rub it gently with a cloth at bath time to remove the softened crust. For a crusty scalp, try massaging a little petroleum jelly or coconut oil into the scalp. Leave it in overnight and wash it out the next day at bath time, removing any crusts soft enough to come away easily.

Newborn rash

Some babies develop a blotchy, red rash all over their bodies soon after birth. This is caused by your baby’s skin coming into contact with new textures such as clothes, cuddly toys and nappies. It doesn’t worry your baby and will soon disappear without treatment.

Heat rash

This is found mostly over your baby’s head and neck, or wherever two skin surfaces come in contact. Consisting of tiny red dots that may join up to form red splotches, heat rash is is common in newborns, regardless of the weather, as their bodies are adjusting to life outside the temperature-controlled womb. The rash will soon fade, though heat rash can recur in hot conditions up to the age of about 3 years. It doesn’t itch or cause distress, so don’t panic.

Hormone rash

Although often called ‘milk rash’, these pimples are unrelated to your baby’s diet. They are thought to arise from the high level of hormones passed from mother to child in labour, which stimulates the sebaceous glands and causes pimples.

Milia

These small ‘white heads’ are often found on babies’ noses at birth. They are caused by blocked sebaceous glands and usually disappear by four to six weeks. Do not squeeze them.

Birthmarks and stork marks

Birthmarks are very common and usually harmless, though your doctor may want to check them as your baby grows. Stork marks are red patches that often occur on babies’ eyelids, on the bridge of the nose between the eyes, on the forehead, or below the hairline at the nape of the neck. They are collections of tiny dilated blood vessels and may take up to 1 year to finally disappear.

Strawberry marks

These are common and are caused by red blood cells escaping from the blood vessels. Appearing in the first six weeks, they are bright red, soft swellings that may grow until the baby is about 9 months old. They then remain unchanged until late in the second year and most fade completely by 3 years old.

Mongolian spots

Mongolian spots are common on dark or olive skinned babies and appear as bruise-like, flat, bluish grey patches around a baby’s bottom, shoulders, back and arms. They are caused by accumulations of pigment under the skin and are usually present at birth but can appear as late as 3 months old. They fade during the first 3 years.

Port wine stains

These red or purple marks, usually on the face, head or neck, are rare and do not fade. They can ultimately be treated with laser therapy or surgery.

Café-au-lait patches

These small, flat, brown or coffee-coloured patches are very common and are usually permanent.

Eyes

Most babies are born with dark blue eyes because melanin, the body’s natural pigment, is not initially present. Red streaks, which are due to tiny blood vessels bursting under pressure during birth, usually disappear quickly. Your baby will not initially cry tears – these will only start to appear after a few weeks, and sometimes as late as 9 months.

Many babies look cross-eyed as their eye muscles are still strengthening, but this usually corrects itself by around 6 months of age. A mild ‘droopiness’ of one eyelid is also very common and usually resolves itself in the first year. A condition known as ‘sticky eye’ affects many babies in the first 3 months after birth. This is usually caused by a blockage in the ducts that drain the eye and usually results in a yellow discharge which is worse when the baby wakes after sleep. Use cool, boiled water to bathe the eyes gently, using one clean CHERUBS cottonwool ball for each wipe. Start near the nose and gently wipe out, then dry the eye in the same way. Breast milk is also good for cleaning sticky eyes. If the eye is very swollen and crusty, and bathing is not helping, you may need to apply antibiotic drops or ointment. Note that while these will clear the discharge, they won’t unblock the tear duct, which will unblock on its own by six months if not earlier. ‘Sticky eye’ is not infectious or harmful and is not the same thing as infectious conjunctivitis that older babies and toddlers sometimes get.

Ears

Your baby’s ears may secrete a lot of wax, which is how the ear cleans itself. Don’t try to remove this – it will roll out on its own. Because the ear tissue is very soft, your baby’s ears might fold forward or look creased. Never try to stick the ears back – it won’t make any difference and will only cause discomfort and irritation. Most ears correct themselves with time.

Noses

Babies breathe rapidly, unevenly and often noisily. The noise is due to their being unable to clear their noses and throats, and their narrow airways causing mucous and milk to accumulate. Inhaling fluff and dust in the air is another reason babies can sound blocked up and noisy when they breathe (although they can sneeze).

Mouth

Small ‘sucking blisters’ sometimes develop on the top lip when babies are getting all their nutrition from sucking. They do not cause any discomfort and do not need any treatment. Babies do not make much saliva until they are 8-12 weeks old so they often have milky-looking tongues. White tongue and blisters can often be confused with thrush. Thrush appears as patchy, white spots on the inside of the lips and cheeks and these cannot be removed by wiping.

Fingernails and toenails

Your baby may have long fingernails but it is best not to cut them for at least the first week as they are very delicate. When you do cut them, wait until your baby is relaxed (or asleep), gently pull away the skin from behind the nail and cut the top off the nail using a pair of small, blunt-ended scissors. Don’t worry if your baby’s toenails are very short and embedded in the nail bed – they will soon grow up and out. The skin around the nails sometimes becomes red and swollen, in which case you can apply some antiseptic cream. Antibiotics are seldom needed.

Red, swollen breasts

Whether you have a boy or a girl, your baby’s breasts may appear slightly swollen, sometimes even with a milky white discharge. This is perfectly normal and is caused by pregnancy hormones passing from you to your baby at birth. The swelling and discharge do not cause discomfort and usually disappear quite soon.

Umbilical cord

After birth the umbilical cord is clamped and cut, leaving a small stump which will dry out within a few hours and become dry and black. The cord falls off by itself within a week or so, but you can help to keep the navel clean by using some surgical spirits on a ball of cotton wool at bath time. Cord infections are rare but watch out for shiny, puffy red skin around the navel and a very strong smell.

Cracking joints and clicking hips

Clicking or cracking knees and shoulders are quite normal. So is a clicking hip, which is caused by loose ligaments around the joint. The same pregnancy hormones that cause hormone rash and swollen breasts soften the ligaments and make them loose. Clicking hips due to stretched ligaments are temporary and need no treatment.

Pink urine

A pink-tinted substance called urate is often present babies’ urine and is not blood. This can continue until the kidneys are mature enough to filter it out (sometimes late as three months) and is nothing to worry about.

Swollen genitals

Babies’ genitals often look swollen as a result of pregnancy hormones and the birth process. Girls may also have a white vaginal discharge and possibly a tiny amount of vaginal bleeding. Both are due to pregnancy hormones and clear as these levels drop. In boys, it is common for the scrotum (the sack around his testicles) to be quite large and swollen. This is known as a hydrocele and usually subsides as the fluid around the testicles is absorbed. Normally there are two testes in the scrotum, which are quite easy to feel. If by the age of 1 you cannot feel one or both of these, you should see your doctor. For family, religious or health reasons, some parents opt to circumcise their baby boys. This involves surgical removal of the foreskin (which covers the tip of the penis) rapidly and without anaesthetic soon after birth. Your baby should be full-term, healthy, gaining weight and not jaundiced.

From the moment he is born, your baby’s senses are flooded with information which in turn stimulates the development of his brain. If you talk, sing and play with your baby from early on, you will help the neural pathways to form in his brain – but you cannot get him to do something – e.g. speak – before these pathways are established. This he will do in his own time at his own developmental rate.

DID YOU KNOW?

Your baby’s brain will more than double in size during his first year

Your brain uses 60% of the energy he gets from food to grow his brain.

From the start, your newborn is able to do certain things that help him survive. What are these?

As soon as your baby is born, he has to use his lungs to obtain the oxygen which he previously absorbed from his mother’s body via the placenta. After taking his first breath he may cough to clear his airways and as soon as he begins to breathe normally, he will probably cry. Hiccups are also common at first, caused by his immature diaphragm contracting irregularly while his muscles are still strengthening. What he is perfectly equipped to do, right from the word go, is to feed and digest food. That’s because he is born with a strongly developed sucking reflex.

Reflexes are ‘inbuilt’ behaviours that your baby is able to do automatically and which help her meet her basic needs. Many of these disappear slowly over the first six months.

The sucking reflex

This reflex is essential for survival, and a strong suck is a sign of a healthy baby. Babies also frequently suck on objects such as fingers, blankets, clothing and pacifiers when they are not hungry, especially when they are overtired or upset. This is called non-nutritive sucking and seems to be an instinctive way of relieving stress and self-soothing.

The rooting reflex

This reflex helps a baby find food. You will notice that when you touch your baby’s cheek, she will turn her head in the direction of the touch and open her mouth to suck. It can help to tickle your baby’s lips lightly when you want her to feed.

The grasping reflex

Many people are surprised at how strong a baby’s grip can be! If you place your finger in your baby’s hand, he will grasp it tightly and if you try to remove finger, his grip will get even tighter.

The Moro or startle reflex

Young babies are easily startled and typically react by flinging out their arms and legs with their fingers and toes spread apart. Then they bring their arms back into their chest with fists clenched and often start to cry. The Moro reflex can makes it hard to settle young babies, which is why some mums wrap or swaddle their babies or holding them firmly to transition them into deep sleep.

Each of your baby’s senses are ready to use the moment he is born. However they take a while to sync with her muscles, so it takes a few weeks for her reactions to become more co-ordinated.

Sight

Babies are short-sighted and you may notice your baby staring at you immediately after birth. Your baby focuses best at 20-25cm away from something, which is roughly the distance between your baby’s face and yours when she is at your breast. She enjoys watching you and can track your movements for short periods, but don’t expose her to too much visual stimulation at once.

Hearing

Babies can hear very well at birth and will recognise the voices they heard while still in the uterus. While they don’t like loud voices or noises, ‘white noise’ like the sound of the washing machine or dishwasher may have a calming effect – as might singing a song you sung to your baby while pregnant.

Taste

Babies have a delicate sense of taste and may be sensitive to the taste of garlic or onions in your breastmilk. If your baby is bottle-fed and seems unsettled, try a different formula. Tasting is your baby’s way of exploring the world and everything will end up in his mouth as he gets older. Don’t discourage this, but always ensure that whatever he puts into his mouth cannot harm him.

Smell

A newborn baby can distinguish surprisingly well between smells, such as his mother’s breast milk versus another mother’s. He may even use smell to help him find the breast. If your baby seems particularly sensitive to smells, try to limit strong odours where possible.

Touch

Most babies love to be cuddled and held close, which generally calms and reassures them. Because babies are quite sensitive to touch, keep their clothing comfortable and their bath water and room temperature at levels they seem happiest, and change their nappies regularly. It has been discovered that babies feel pain in the same way we do, if not more.

Your baby has his own personality from the moment he is born, with his own likes and dislikes. Because he has a limited way of communicating with you, you’ll learn his personality from observing him and be better able to work out what he wants.

If your baby cries a lot and has difficulty settling into a regular sleeping pattern or feeding schedule, he could be highly sensitive to stimulation. Such a baby would respond best to peace and quiet rather than bright lights and lots of stimulation. Take care to introduce him to new people and situations slowly to give him plenty of time to adjust. A relaxed, laid-back baby adapts to new people and places easily and has fewer sleeping and eating problems. If your baby is like this, beware of accidentally overstimulating him. If you notice his interest diminishing, or he suddenly falls asleep, give him a break.

Crying is your baby’s primary form of language and a sign of healthy development. The challenge is to learn what type of cry means what! Establishing a regular sleeping and feeding routine may help you to distinguish between your baby’s ‘hungry’, ‘tired’ or ‘bored’ cries because, when he starts to cry, you will know what is due next on the routine – and what is therefore probably causing the fuss.

All babies cry in different ways, but the one common factor is that babies cry because they need something and are asking you to meet that need. Always look for an explanation as babies rarely cry just for the sake of it. Your baby may be saying: